President-elect Donald Trump’s proposal to repeal the Medicaid expansion as part of rolling back most of the Affordable Care Act (ACA) would harm New Jersey far more than most other states, causing over a half million low-income residents to lose health coverage and costing the state about $3 billion a year in federal funds. This would reverse the progress New Jersey has made in reducing the number of residents without insurance while deepening the state’s severe financial and budget crisis. New Jerseyans across the state, as well as hospitals and other health care providers, would be harmed.

The option for states to expand Medicaid took effect January 1, 2014 and allows them to raise eligibility to a higher, uniform national level and, for the first time, include adults without children at a much higher federal matching rate to make it easier for states to cover more Americans.

Given the threat the Trump proposal poses to New Jersey, the state’s Congressional delegation must strongly oppose any repeal of the Affordable Care Act, including the Medicaid expansion; Gov. Christie should use his influence to ensure that the expansion stays in place; the legislature should hold hearings and urge Congress to keep the expansion intact; and the state should stay the course and help more uncovered people enroll.